Transcutaneous Raman Spectroscopy for Diagnosis of Diabetic Osteomyelitis Diabetic foot ulcers often lead to metatarsal or calcaneal osteomyelitis, a serious complication that can require prolonged administration of antibiotics, surgical debridement or even amputation for curative treatment. Current methods available for the diagnosis of diabetic foot osteomyelitis are inadequate and costly. The development of a non-invasive diagnostic device to define changes in metatarsal bone composition and quality that are specific for diabetic osteomyelitis would have potential as a cost-effective diagnostic adjunct to current clinical criteria. For many years we and others have been using near infrared spectroscopy as a platform technology to define bone quality in vivo. Our methods employ a specific type of near-infrared spectroscopy known as Raman spectroscopy and we have termed our approach to in vivo use as Transcutaneous Raman Spectroscopy (TRS). Our long-term translational goal is to develop a TRS device specifically for determination of metatarsal and calcaneal bone composition and quality in diabetic patients with foot ulcers for the diagnosis of osteomyelitis. In this application we have proposed three specific aims that will allow us to begin the translational development of TRS as a diagnostic device. Specific Aim 1: Determine the Raman spectral patterns that are characteristic for diabetic osteomyelitis using samples of bone obtained during surgical treatment or amputation. Specific Aim 2: Develop TRS device probe/detector prototypes optimized to determine metatarsal and calcaneal bone composition and quality when applied to the plantar surface of the human foot. Specific Aim 3: Perform an initial cross-sectional study of the TRS device probe/detector prototypes in normal healthy volunteers to define the Raman spectral patterns that characterize composition and quality of normal metatarsal and calcaneal bone. PUBLIC HEALTH RELEVANCE: Patients with diabetes frequently get foot ulcers and these ulcers can lead to infection of foot bones. Early diagnosis of infected foot bones would improve treatment. We propose to develop a hand held device that would use laser light to identify infected bone in patients with diabetic foot ulcers.